Photo by Lawrie Robertson

Which local cancer organization has nearly 300 faculty, $112 million in funding from the National Cancer Institute, 16 research programs - of which 10 recently received the highest possible rating from peers - and more than 750,000 net square feet devoted to research space for cancer-related programs?

The answer: the newly developed Fred Hutchinson/University of Washington Cancer Consortium.

The consortium consists of Fred Hutchinson, the UW (including the School of Medicine and the School of Public Health and Community Medicine) and Children's Hospital and Regional Medical Center.

In February, the three institutions jointly submitted an application for a Cancer Center Support Grant to the NCI. The grant was reviewed in June, and the draft site-visit report was issued July 19.

Peer reviewers were impressed with the new cancer-consortium arrangement, according to the summary from the overall critique.

Critique: 'superb job'

"The new Consortium Cancer Center, building on the outstanding strengths of [Fred] Hutchinson, shows promise for making continued advancements in cancer research, and the senior leadership of the three participating institutions in the consortium [has] done a superb job in building it so as to effect synergies in clinical cancer care and clinical research," the critique said.

The critique noted the efforts of Dr. Lee Hartwell, center president and director, in the process:

"Dr. Hartwell has done an outstanding job in incorporating the stronger cancer research efforts of the participating institutions to strengthen the Cancer Center Support grant."

The formation of the Seattle Cancer Care Alliance, the critique said, "should provide a focus for enhanced translational and clinical research of both adults and pediatric populations, particularly the strengthening of the still-developing solid tumor areas. The outstanding strengths in basic research and population sciences remain as major strengths of the application."

The conclusion of the critique was clear:

"The overall quality of the application is judged to be outstanding and support is enthusiastically recommended for five years."

Rated as outstanding to excellent were Epidemiology and Pediatric Oncology, while Molecular Imaging was rated as excellent to outstanding.

(Note: Two consortium programs, Genetics and Cancer Biology, were not included in the grant application because of concerns that reviewers might be confused by having investigators appearing in several programs. Many investigators in these programs were included in the Human Biology program).

The three disease-specific research programs (Breast Cancer, Prostate Cancer and Gynecologic Oncology) received slightly lower ratings, due in large part to the lack of well-developed therapeutic trials in these programs. Reviewers indicated that more work is needed to build strong translational and clinical programs in the significant adult solid tumors.

"Part of the solution to the challenge is to hire strong clinicians interested in solid tumors with the responsibility to implement translational research at the bedside," the reviewers said. "The ability to accomplish this will hinge on the establishment of a consortium-wide academic career track that supports their clinical research effort and rewards the scientific accomplishments of clinical investigators."

The consortium leaders were not surprised by reviewers' solid-tumor program comments, as these same topics have been under discussion in recent consortium Institutional Planning Committee meetings, along with discussion about improvements to the research infrastructure for solid tumors.

In fact, one of the primary reasons that a decision was made to form the consortium was the need for the UW, Children's and Fred Hutchinson to work together to improve systems and coordinate investments in recruitment and research infrastructure, so that the mutual goals of all three institutions to be world leaders in cancer research can be realized as rapidly and efficiently as possible.

Shared Resources support

The Cancer Center Support Grant is vital to the support of shared resources, which are core services that provide researchers access to expensive and/or cutting-edge technologies that are difficult to maintain in individual laboratories.

Twenty-three shared resources requested $3.9 million in direct support from the grant. The reviewers recommended funding for all of the requested shared resources, in the amount of $3.3 million, a 32 percent increase over the current year. Several newer resources received less than the full-funding request, mostly because they weren't fully developed or they primarily supported solid-tumor clinical trials, which require a stronger track record to obtain maximum support.

Other key areas that received major increases in funding to reflect the increased size and complexity of the grant included senior leadership, administration and developmental funds.

At $1.1 million, the request for developmental funds was more than 60 percent higher than the current-year funding from the Cancer Center Support Grant, and reviewers recommended full funding for the request, stating that the prior and proposed uses of funds were outstanding.

The dollars will be used to recruit 20 new faculty within the consortium and to develop new shared resources in high-throughput genomics, molecular imaging, and what is known as immune monitoring.

The Scientific Steering Committee will make recommendations for use of recruitment funds to Lee Hartwell, who serves as consortium director. Recruitment funds will target solid-tumor clinical researchers, scientists who combine population-based research with laboratory research, and leaders in genomics, transcriptomics, proteomics and bioinformatics.

The total first-year direct funding recommended by the reviewers was $5.8 million, a 41 percent increase over funding for this year's Fred Hutchinson-only Cancer Center Support Grant.

The NCI subcommittee and the National Cancer Advisory Board will decide the final award. The NCI subcommittee at that meeting also will award the final priority score.

Next steps

Now that the consortium has received positive reviews, many steps must be implemented to prepare for operations by next January.

The most immediate need is to include UW and Children's protocols that relate to cancer in the protocol registration, review and monitoring systems required by NCI. Another key task is to expand access to NCI-funded shared resources to all consortium members at all three participating institutions, and to address the many transportation, communication and billing issues that are involved in the expansion.

To prepare for this process, the Scientific Steering Committee and Institutional Planning Committee of the consortium reviewed the shared resources, their funding and their strategic requirements in the spring. A survey of potential new users was performed in May, and a survey of current users is being completed this summer.

Determination of how ongoing capital needs will be met is still under discussion in the Administrative Operations group. An Internet site for the consortium will be developed, and an expedited strategic plan, using the grant application and review as a beginning template, is being developed.

The Institutional Planning Committee also is working on ways to measure the impact of the consortium on grant base and publications. After all, putting this concept together was a lot of work, and everyone is concerned that we be able to demonstrate measurable benefit for the efforts of all involved.

A key goal of the consortium is to increase scientific collaboration and interdisciplinary interactions across the participating institutions, so several steps are being taken to meet this goal.

Consortium program heads and scientific leaders will meet annually in a retreat to talk about new opportunities and to review current programs and assess recommendations of the External Advisory Committee. Every other year, a consortium-wide retreat will occur, to promote interaction and communication among members. In addition, the administrative team is working on ways to reduce bottlenecks that make it difficult for investigators across institutions to collaborate on grants.

Work is under way to streamline subcontracts and staff-investigator support, and in the fall a group will begin work on streamlining the industry-contract process. In 2001, there were $7 million in subcontracts from Fred Hutchinson to the UW, and $5 million in subcontracts from the UW to Fred Hutchinson. With improved coordination and collaboration, these dollar amounts should be much higher in the next Cancer Center Support Grant submission.

Valuable process

In summary, the process of developing the consortium and describing it in the immense detail required by the NCI was valuable for all concerned.

"Each of our institutions brings considerable strengths that are essential to world class cancer research," Lee Hartwell said at the site visit.

"We live in a time of unprecedented opportunity in science, and with the completion of the Alliance clinic and the Public Health Sciences buildings, we will have all of the disciplines and many of the cancer investigators from all three institutions co-located for the first time. Together, we can accomplish things that no individual institution anywhere could hope to accomplish."

Further progress will be reported in Center News and in a new consortium newsletter available on the Internet and via e-mail.

[Peggy Means is the executive vice president and chief operating officer for Fred Hutchinson.]

Who's who on the Consortium's Institutional Planning Committee

The Institutional Planning Committee is charged with implementing the strategic scientific goals of the consortrium and managing the various scientific planning functions.

Who's who on the Consortium's Scientific Steering Committee

The Scientific Steering Committee fosters scientific planning for the consortium. Each program has two faculty representatives on the committee, usually the program head and associate head. The committee is chaired by Dr. Stan Riddell. Vice chairs are Drs. Larry Loeb and Mary Anne Rossing.

Additional members:
Maynard Olson, Chris Wilson

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